Can I take Empagliflozin and Rybelsus together?

Why this happens

Both medicines work to lower blood sugar but in different ways. Empagliflozin (Jardiance) makes you pass sugar out through your urine, while Rybelsus (semaglutide) helps your body release more insulin. Because they both lower blood sugar, their combined effect is much stronger. Additionally, empagliflozin is a diuretic (water pill) effect, which can lead to fluid loss.

What you should do

You should only take these together if prescribed by your doctor. Monitor your blood sugar levels regularly. Learn to recognise signs of 'hypos' (such as shaking, sweating, or confusion) and keep a fast-acting sugar source nearby. Ensure you drink plenty of water to stay hydrated. If you feel very unwell, nauseated, or have stomach pain, contact your doctor immediately.

Important precautions

Dehydration and Diabetic Ketoacidosis (DKA)

You must stop taking empagliflozin and seek urgent medical help if you become very unwell, lose your appetite, or have persistent vomiting/diarrhoea. This is to prevent a rare but serious condition called ketoacidosis, which can occur even if your blood sugar levels are normal.

Pancreatitis

Stop taking Rybelsus and contact your doctor immediately if you experience severe, persistent stomach pain that may radiate to your back, as this can be a sign of an inflamed pancreas (pancreatitis).

Fournier’s gangrene - empagliflozin

Seek immediate medical attention if you experience severe pain, tenderness, redness, or swelling in the genital or anal area, accompanied by fever or a general feeling of being unwell.

Foot ulcers

Check your feet regularly and tell your doctor immediately if you develop any sores, ulcers, or infections, as empagliflozin may increase the risk of lower limb amputations if foot care is neglected.

Diabetic retinopathy - Rybelsus

If you have diabetic eye disease, tell your doctor immediately if you notice any changes in your vision during treatment, as rapid improvements in blood sugar can temporarily worsen this condition.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Alcohol can interfere with blood sugar control and increases the risk of a serious condition called ketoacidosis (with empagliflozin) or low blood sugar (hypoglycaemia). Drinking alcohol can also increase the risk of inflammation of the pancreas (pancreatitis) when taking Rybelsus.

Water and fluids

It is essential to drink plenty of water and stay well-hydrated. Empagliflozin works by removing sugar through your urine, which increases the amount of fluid you lose. This can lead to dehydration and low blood pressure if you do not drink enough fluids.

Food and drink (general)

Rybelsus must be taken on an empty stomach. You should wait at least 30 minutes after taking your tablet before having your first food, drink (other than plain water), or other oral medicines. If you eat or drink too soon, the medicine will not be absorbed properly and will not work.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.